Fatores prognósticos no Mieloma Múltiplo

Abstract

Over the last 10 years, great changes have occurred in the treatment of multiple myeloma (MM) due to the use of new drugs. Considering the new options, it is essential to recognize clinical and biological parameters to arrive at the best therapeutic choice. More recently the new International Staging System (ISS) for multiple myeloma was validated which utilizes two straight forward laboratory parameters: the β2 microglobulin (β 2M) and albumin levels. Stage I: β 2M < 3.5 mg/L and albumin level ≥ 3.5 g/dL with a median survival of 62 months; stage II: β 2M < 3.5 and albumin < 3.5 g/dL or β 2M > 3.5 to < 5.5 g/dL with a median survival of 49 months; stage III: ≥ 5.5 g/dL with a median survival of 29 months. The importance of cytogenetics and molecular features as prognostic factors is being recognized. Deletion of chromosome 13 or 13q, the t(4:14) translocation, p53 deletion and amplification of chromosome band 1q21 are all associated with poor prognosis.